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Updating evidence role corticosteroids severe sepsis septic shock

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During past decades, many strategies have been implemented with the aim of optimizing the outcome of patients with severe lung infections.

State of immunocompromisation during severe pneumonia related to multiple drug-resistant infections which may contribute to severe hypoxemic respiratory failure triggering septic shock and fatal outcome associated with multiple organ dysfunction syndromes.

RESULTS: Corticosteroid efficacy, compared with control, for hospital-mortality, proportion of patients experiencing shock-resolution, and infective and non-infective complications was assessed using Bayesian random-effects models; expressed as odds ratio (OR, (95% credible-interval)).

METHODS: RCTs were identified (1950-September 2008) by multiple data-base electronic search (MEDLINE via OVID, OVID Pre Medline, OVID Embase, Cochrane Central Register of Controlled trials, Cochrane database of systematic reviews, Health Technology Assessment Database and Database of Abstracts of Reviews of Effects) and hand search of references, reviews and scientific society proceedings.

INTRODUCTION Current low (stress) dose corticosteroid regimens may have therapeutic advantage in severe sepsis and septic shock despite conflicting results from two landmark randomised controlled trials (RCT).

METHODS RCTs were identified (1950-September 2008) by multiple data-base electronic search (MEDLINE via OVID, OVID Pre Medline, OVID Embase, Cochrane Central Register of Controlled trials, Cochrane database of systematic reviews, Health Technology Assessment Database and Database of Abstracts of Reviews of Effects) and hand search of references, reviews and scientific society proceedings.

Recent studies assess beneficial impact on treatment of severe pneumonia by suggesting specific dosage, period of administration, and tapered dosage.

Severe pneumonia patients represent a major concern for physicians because of the high mortality and morbidity rate attributed to these episodes [1].

Length of stay in the Sepsis occurs when an infection is complicated by organ failures as defined by a sequential organ failure assessment (SOFA) score of two or higher.

Sepsis may be complicated by impaired corticosteroid metabolism.

Current low (stress) dose corticosteroid regimens may have therapeutic advantage in severe sepsis and septic shock despite conflicting results from two landmark randomised controlled trials (RCT).

We systematically reviewed the efficacy of corticosteroid therapy in severe sepsis and septic shock.

Department of Pulmonary Medicine, Zhongshan Hospital, Shanghai Medical School of Fudan University, 180 Fenglin Road, Shanghai 200032, China Received 9 July 2013; Accepted 2 November 2013Academic Editor: Elena Voronov Copyright © 2013 Felinda Ariani et al.

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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